[Observation of newborn, Contribution to the "sudden infant death syndrome" (SIDS) (author's transl)]. / Uberwachung von Neugeborenen. Ein Beitrag zum "Sudden Infant Death Syndrome" (SIDS).

The occurrence of sudden child death in the Gynaecological Department of the Free University has led to the development of special monitors, on which all the children can be observed while their mothers are in the maternity ward. Our findings show that apnoeic intervals occur among newborn children more frequently than is generally assumed. Whether, and to what extent attacks of apnoe can lead to sudden child death can not be determined from our own statistics. In the literature, which is cited individually, a direct correlation is described by very many authors. Almost all of them agree that through continuous monitoring of breathing it is often possible to register risk situations for newborns before a real disease becomes manifest. Our experience justifies the demand that every child's respiration be monitored, especially in clinics which handle a large number of risk pregnancies and births.

[Effect of lactobacillus immunotherapy on genital infections in women (Solco Trichovac/Gynatren)]. / Wirkung einer Lactobazillus-Immuntherapie auf die Genitalinfektion der Frau (Solco Trichovac/Gynatren).

In view of the high cure rates of Trichomonas vaginitis after vaccination with the immunotherapeutic drug Solco Trichovac Gynatren, the therapeutic efficacy of this regimen in nonspecific vaginitis was investigated. 94 patients were treated in a multicentre study. Concurrent with a decrease of pathogens, the growth of a normal lactobacilli flora was observed. The degree of vaginal purity according to Schröder and the vaginal pH returned to normal. A cure or at least a marked improvement of symptoms was documented in about 80% of patients. Compared to conventional forms of therapy, this regimen protects against reinfection, thus providing a decisive advantage.

[Cervical pregnancy with twin fetuses (author's transl)]. / Zervikale Zwillingsschwangerschaft.

A case of a histologically confirmed cervical twin gestation in a 37-year old gravida 3, is reported. The pregnancy resulted in rupture of the uterus during the 18th week of gestation. A hysterectomy had to be performed to control the hemorrhage.

[Successful pregnancy, following kidney transplantation. Brief account of additional cases reported in literature (author's transl)]. / Erfolgreiche Schwangerschaft nach Nierentransplantation. Kurzer Uberblick über weitere Fälle in der Literatur.

A primigravida, 37 years of age, gave birth to a healthy girl, one and a half year from transplantation of a postmortem kidney. The treatment, using immunosuppressors, and pregnancy monitoring are described in greater detail. -- A brief account is also given of additional cases of pregnancy of kidney transplant recipients. Aspects relating to high-risk pregnancy and possible consequences of immunosuppressive therapy are discussed.

[The value of continuous respiration monitoring in the early diagnosis of potentially life-threatening diseases in newborn infants]. / Der Stellenwert der kontinuierlichen Atemüberwachung bei der Früherkennung potentiell lebensbedrohlicher Erkrankungen des Neugeborenen.

In 1983, 1 466 newborn children were monitored with the help of "apnea mattresses" during hospitalization in the Klinikum Steglitz. Sixteen children were transferred to the Pediatric Clinic for further diagnosis because of pathological respiratory rate patterns. Fourteen of those children had pathological findings with a predominance of infectious problems. Major health disorders in newborns seem to announce themselves, among other things, by an irregular breathing pattern. An early diagnosis of it is possible with the help of continuous respiratory monitoring.

[The relevance of "family-oriented obstetrics" and its consequences for the maternity hospital (author's transl)]. / Die Bedeutung einer "Familienorientierten Geburtshilfe" und ihre Ionsequenzen für die Entbindungsklinik.

By inventing the "rooming in", the organisational prerequisites for the undisyurbed early mother--child relationship, which is of fateful relevance for the newborn, are provided. Since part of the responsibility for the child is transferred to the mother already in the hospital, an adequate instruction is necessary. Thus, a change is taking place pertaining to the tasks of the nursing personnel. In an inquiry made on 950 female patients, the social-psychological aspects of the "romming in" were examined and evaluated. The joint accommodation of mother and child ought to be available on request for approximately 50% of the delivered women. During the night the newborns should be taken to the nursery. This meets with the needs of many women for undisturbed rest during the night despite "rooming in" and also with the necessity for control of the newborns by the nursing staff. The general judgment of the patients on a clinic cannot be changed essentially by the invention of "rooming in". This is depending to a great extent on various other factors.

[Socio-psychological factors of "family-oriented obstetrics", including "rooming in" (author's transl)]. / Sozialpsychologisehe Faktoren einer "Familienorientierten Geburtshilfe" unter Einschluss des "Roomin In".

The introduction of the "rooming in" system to maternity wards of many hospitals has been accompanied by additional demands on the hospital made by parents together with their desire tor "natural birth". Therefore, additional factors have to be taken into due consideration in the context of "family-oriented obstetrics". Interviews were made with 1,000 mothers, just after delivery to find out what they thought about certain marginal conditions in maternity advisory centres, delivery rooms, and on maternity wards. Their replies were statistically evaluated.

Trisomy 14 mosaicism leading to cytogenetic discrepancies in chorionic villi sampled at different times.

Short- and long-term cultures of chorionic villi obtained in the 11th week of pregnancy revealed trisomy 14. After induced abortion trisomy 14 mosaicism was established in fetal skin and umbilical cord tissue while a second long-term culture of chorionic villi exhibited a normal karyotype. The results of the pathological investigations are discussed with respect to the cytogenetic findings.

[Examination of cardiac function following long-term tocolysis with fenoterol and isoxsuprine in newborn (author's transl)]. / Untersuchung der Herzfunktion nach Langzeittokolyse mit Fenoterol und Isoxsuprin bei Neugeborenen.

We can sum up as follows: In special cases, tocolytics can lead to complications in the mother as well as in the foetus. These may be partly so severe that lead to patient's death, as some case histories show. In the majority of cases, however, there are only slight transient changes which are no longer manifest after a few weeks' time. Hence, it should be mandatory to initiate special cardiologic supervision of the children during the perinatal period if administration of tocolytics was unavoidable for the purpose of maintaining the state of pregnancy. It would be optimal if these patients, besides being examined clinically, would also be examined via echocardiogram, electrocardiogram and CK-MB determination. Since the echocardiographic examination, in particular, entails a great deal of expenditure of time and requires a relatively complicated instrumental set-up, we believe that recording the ecg and CK-MB should suffice, as practicable examination parameters in clinical routine, to detect this damage of the myocardium well in time.

[Experiences with transcervical chorionic villi biopsy in 274 studies]. / Erfahrungen mit der transzervikalen Chorionzottenbiopsie bei 274 Untersuchungen.

In the years 1985-1987, 274 transcervical chorionic villi biopsy samples were taken at the Klinikum Steglitz Medical Center of the Free University of Berlin. We have information on the outcome of 264 pregnancies (96.3%). 229 cases (83.6%) yielded diagnostically usable results. Multiple biopsy samples were taken in 59 (21.5%) cases. Abnormal results were found in 14 patients. Pregnancy was terminated in 6 cases (2.2%) for proven chromosomal aberrations. In two others, spontaneous abortion occurred before the intended induced abortion. In 4 cases of mosaics, amniocentesis was performed subsequently in the 16th week of pregnancy; three of those pregnancies were carried to full term, and the children are healthy. In one case, we saw a spontaneous abortion in the 26th week of pregnancy. In two cases, we found balanced translocations. Miscarriage was observed in 16 CVS patients (5.8%). Abortion was febrile in two cases, septic in two others.

[Bacteriologic findings before and in transcervical chorionic villi biopsy and their clinical relevance]. / Bakteriologische Befunde vor und bei transzervikaler Chorionzottenbiopsie und deren klinische Relevanz.

Between August 1987 and May 1989, bacteriological examinations of smears from the cervical canal was performed in 358 pregnant women, who underwent transcervical sampling of chorionic villi. The outcome of 349 of these pregnancies is documented. 12 of these patients (3.5%) had an artificial abortion for genetic reasons. In 12 other patients, the pregnancy ended before 28 weeks (one child surviving). Microbiological examinations showed that in 187 women (52%), it was possible to culture one or more microorganisms from the cervical canal. The most frequently detected pathogen was Chlamydia trachomatis (111 women, 31%). In pregnancies, where more than one microorganism could be cultured, the risk of following abortion was 8.9 times higher than in those, where no pathogens could be found. In only two of the 12 women with a subsequent spontaneous abortion (16.6%), no microorganism could be found. The bacterial contamination of the cervical canal during TC-CVS seems to be a risk factor for subsequent abortion. Therefore, a bacteriological examination of cervical flora should be performed before as well as during TC-CVS, and antibiotic therapy should be initiated in case of positive results.

Genetic amniocentesis in twin pregnancies: results of a multicenter study of 529 cases.

To evaluate the risk of abortion after genetic amniocentesis in twin pregnancies, a retrospective study of 15 centers was performed. The spontaneous abortion rate up to 20 completed weeks of gestation was 2.3%; the abortion rate up to 28 completed weeks, as defined by WHO, was 3.7%. The abortion rate could not be correlated either with the number of needle insertions or with the type of marker dye used. There was also no correlation between the abortion rate and the gestational age at which amniocentesis was performed. A significant association was shown between congenital intestinal obstructions and the application of methylene blue intra-amniotically as a marker dye. Considering the increased natural loss rate in multiple gestations, amniocentesis in twin pregnancies seems to be a safe and reliable technique.